中华物理医学与康复杂志
中華物理醫學與康複雜誌
중화물리의학여강복잡지
CHINESE JOURNAL OF PHYSICAL MEDICINE AND REHABILITATION
2014年
9期
694-697
,共4页
解东风%李奎%陈颖蓓%李鑫%付奕%许长城%吴丹丽%梁明%郑雅丹
解東風%李奎%陳穎蓓%李鑫%付奕%許長城%吳丹麗%樑明%鄭雅丹
해동풍%리규%진영배%리흠%부혁%허장성%오단려%량명%정아단
外周磁刺激%膝踝足矫形器%脑卒中%偏瘫%下肢
外週磁刺激%膝踝足矯形器%腦卒中%偏癱%下肢
외주자자격%슬과족교형기%뇌졸중%편탄%하지
Magnetic stimulation%Knee-ankle-foot orthoses%Stroke%Hemiplegia%Walking%Balance%Lower limbs
目的 观察膝踝足矫形器(KAFO)训练联合外周磁刺激对脑卒中重度偏瘫患者下肢功能恢复的影响.方法 采用随机数字表法将60例下肢严重瘫痪的脑卒中偏瘫患者分为治疗组(30例)及对照组(30例).对照组给予常规康复治疗(基于运动再学习技术)及KAFO训练,治疗组则在对照组干预基础上针对偏瘫侧髂腰肌进行磁刺激治疗,2组患者均持续治疗8周.于治疗前、治疗8周后分别采用简化Fugl-Meyer下肢功能量表(FMA-LE)对患者下肢运动功能进行评定,采用Berg平衡量表(BBS)对患者平衡功能进行评定,采用功能性步行分级(FAC)对患者步行功能进行评定,采用改良Barthel指数量表(MBI)对患者日常生活活动能力进行评定.结果 经8周治疗后,发现治疗组患者FMA-LE、BBS、MBI评分分别由治疗前(7.50±2.16)分、(5.57±1.91)分和(21.77±5.50)分提高至(13.63±3.13)分、(19.63 ±2.91)分和(51.10 ±9.09)分;对照组上述指标则分别由治疗前(7.53 ±2.05)分、(5.87±1.43)分和(21.53 ±5.44)分提高至(11.30±2.49)分、(15.50±2.90)分和(42.97±6.24)分;并且治疗组患者上述疗效指标改善幅度均显著优于对照组(P＜0.05).治疗后2组患者FAC分级亦较治疗前明显改善(P＜0.05),并且治疗组FAC分级改善幅度亦显著优于对照组(P＜0.05).结论 KAFO训练联合外周磁刺激能进一步改善脑卒中重度偏瘫患者下肢运动功能、平衡功能、步行能力及ADL能力,该联合疗法值得临床推广、应用.
目的 觀察膝踝足矯形器(KAFO)訓練聯閤外週磁刺激對腦卒中重度偏癱患者下肢功能恢複的影響.方法 採用隨機數字錶法將60例下肢嚴重癱瘓的腦卒中偏癱患者分為治療組(30例)及對照組(30例).對照組給予常規康複治療(基于運動再學習技術)及KAFO訓練,治療組則在對照組榦預基礎上針對偏癱側髂腰肌進行磁刺激治療,2組患者均持續治療8週.于治療前、治療8週後分彆採用簡化Fugl-Meyer下肢功能量錶(FMA-LE)對患者下肢運動功能進行評定,採用Berg平衡量錶(BBS)對患者平衡功能進行評定,採用功能性步行分級(FAC)對患者步行功能進行評定,採用改良Barthel指數量錶(MBI)對患者日常生活活動能力進行評定.結果 經8週治療後,髮現治療組患者FMA-LE、BBS、MBI評分分彆由治療前(7.50±2.16)分、(5.57±1.91)分和(21.77±5.50)分提高至(13.63±3.13)分、(19.63 ±2.91)分和(51.10 ±9.09)分;對照組上述指標則分彆由治療前(7.53 ±2.05)分、(5.87±1.43)分和(21.53 ±5.44)分提高至(11.30±2.49)分、(15.50±2.90)分和(42.97±6.24)分;併且治療組患者上述療效指標改善幅度均顯著優于對照組(P＜0.05).治療後2組患者FAC分級亦較治療前明顯改善(P＜0.05),併且治療組FAC分級改善幅度亦顯著優于對照組(P＜0.05).結論 KAFO訓練聯閤外週磁刺激能進一步改善腦卒中重度偏癱患者下肢運動功能、平衡功能、步行能力及ADL能力,該聯閤療法值得臨床推廣、應用.
목적 관찰슬과족교형기(KAFO)훈련연합외주자자격대뇌졸중중도편탄환자하지공능회복적영향.방법 채용수궤수자표법장60례하지엄중탄탄적뇌졸중편탄환자분위치료조(30례)급대조조(30례).대조조급여상규강복치료(기우운동재학습기술)급KAFO훈련,치료조칙재대조조간예기출상침대편탄측가요기진행자자격치료,2조환자균지속치료8주.우치료전、치료8주후분별채용간화Fugl-Meyer하지공능량표(FMA-LE)대환자하지운동공능진행평정,채용Berg평형량표(BBS)대환자평형공능진행평정,채용공능성보행분급(FAC)대환자보행공능진행평정,채용개량Barthel지수량표(MBI)대환자일상생활활동능력진행평정.결과 경8주치료후,발현치료조환자FMA-LE、BBS、MBI평분분별유치료전(7.50±2.16)분、(5.57±1.91)분화(21.77±5.50)분제고지(13.63±3.13)분、(19.63 ±2.91)분화(51.10 ±9.09)분;대조조상술지표칙분별유치료전(7.53 ±2.05)분、(5.87±1.43)분화(21.53 ±5.44)분제고지(11.30±2.49)분、(15.50±2.90)분화(42.97±6.24)분;병차치료조환자상술료효지표개선폭도균현저우우대조조(P＜0.05).치료후2조환자FAC분급역교치료전명현개선(P＜0.05),병차치료조FAC분급개선폭도역현저우우대조조(P＜0.05).결론 KAFO훈련연합외주자자격능진일보개선뇌졸중중도편탄환자하지운동공능、평형공능、보행능력급ADL능력,해연합요법치득림상추엄、응용.
Objective To study the effects of peripheral magnetic stimulation combined with a knee-anklefoot orthosis (KAFO) for improving lower limb function in severe hemiplegia after stroke.Methods Sixty stroke patients with severe hemiplegia were randomly divided into treatment group and a control group with 30 in each.The patients in the control group received a conventional rehabilitation program including a KAFO.The patients in the treatment group received in addition magnetic stimulation of the iliopsoas muscle on the hemiplegic side.The treat ment of both groups lasted for 8 weeks.Lower limb motor function,balance,walking and ability in the activities of daily living (ADL) were assessed with the Fugl-Meyer lower extremity assessment (FMA-LE),the Berg balance scale (BBS),functional ambulation classification (FAC) and the modified Barthel index (MBI) before and after treatment.Results After 8 weeks of treatment the FMA-LE,BBS,FAC and MBI scores had all improved signifi cantly in both groups,but the patients in the treatment group had improved significantly more than the controls.Conclusion Peripheral magnetic stimulation combined with a KAFO can improve motor function,balance,walking and ADL performance in stroke patients with severe hemiplegia better than a KAFO alone.
